Unite Us enables real-time coordination between health care and community services for vulnerable populations. It uses an outcomes-focused coordinated network model for facilitating cross-sector, collaborative care and data sharing between health care, government, and social services. It is designed to ensure that all providers working in a centralized network can simultaneously address the co-occurring needs of patients, and track outcomes for their patients across the community. Its patient-centered coordination and electronic referral management software bridges the gap between clinical care and social services to address the social determinants of health. Unite Us electronically connects health and community providers around every patient, allowing providers to track patient progress, have 360-degree visibility into their patients’ health journey in the community, while reporting tangible outcomes across a full range of services in a centralized system. The platform can be configured around the workflows, data needs, and programs of any partner and deployed to serve any specific population or service need. It is available in English for provider software while patient-facing access can be translated into any language.
With Unite Us, community networks have achieved: 96 percent accuracy of electronic referrals, 88 percent improvement in coordination efficiency, and 84 percent of patients receiving specific resolved health and social outcomes delivered by external partners. The technology has enabled network partners to remove significant administrative costs, and significantly reduced the time to care for both health care and social services. Network stakeholders and community providers utilize outcome data to measure impact while addressing gaps in respective communities. Case study examples are available here and here for network data from Charlotte, North Carolina.
Alliance for Better Health (DSRIP Medicaid), Institute for Veterans and Military Families (Syracuse University), 2-1-1 San Diego, United Way of South Hampton Roads, Illinois Joining Forces, The State of Rhode Island, The City of New York, United Way of Miami-Dade, Skinny Gene (Medicare Diabetes Prevention Program), 2-1-1 North Carolina
Updated: July 2018
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